The role of Xpert MTB/RIF in diagnosing pulmonary tuberculosis in post-mortem tissues.
The role of Xpert MTB/RIF in diagnosing pulmonary tuberculosis in post-mortem tissues.
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DOI：
10.1038/srep20703
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发表时间：
2016-02-10
影响因子：
4.6
通讯作者：
Martínez MJ
中科院分区：
文献类型：
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作者：
García-Basteiro AL;Ismail MR;Carrilho C;Ussene E;Castillo P;Chitsungo D;Rodríguez C;Lovane L;Vergara A;López-Varela E;Mandomando I;Lorenzoni C;Ordi J;Menéndez C;Bassat Q;Martínez MJ
Xpert MTB/RIF（Gene Xpert）在痰液和脑脊液以外的样本中对结核病（TB）诊断的贡献程度仍不确定。我们旨在评估Xpert MTB/RIF检测M的作用。尸体组织中的结核病我们在马普托中心医院（莫桑比克）进行的30例完整诊断性尸检（CDA）中进行了研究。在所有病例中，肺组织都进行了结核筛查。此外，当在组织学检查中识别出相容性病变时，我们还检测了其他组织。结核病DNA根据微生物学和组织病理学结果确定死亡时的结核病诊断。8/30例（26.7%）诊断为结核病。Xpert检测肺组织中TB的灵敏度为87.5%（95% CI：47.3-99.7），特异性为95.7%（95% CI：78.1-99.9）。内部DNA扩增方法和Xpert显示肺组织的一致性为93.6%，脑和肝组织的一致性为100%。4例死亡的最终原因是肺结核。Xpert MTB/RIF可能是一种有价值的、易于执行的死后结核病诊断技术。
The extent to which the Xpert MTB/RIF (Gene Xpert) contributes to tuberculosis (TB) diagnosis in samples other than sputum and cerebrospinal fluid remains uncertain. We aimed to assess the role of Xpert MTB/RIF for detecting M. tuberculosis in post-mortem tissues. We conducted a study among 30 complete diagnostic autopsies (CDA) performed at the Maputo Central Hospital (Mozambique). Lung tissues were screened for TB in all cases. In addition other tissues were tested when compatible lesions were identified in the histological exam. We used in-house real time PCR and LAMP assays to confirm the presence of M. tuberculosis DNA. The diagnosis of tuberculosis at death was established based on microbiological and histopathological results. Eight out of 30 cases (26.7%) were diagnosed of tuberculosis. Xpert had a sensitivity to detect TB in lung tissue of 87.5% (95% CI 47.3–99.7) and a specificity of 95.7% (95% CI: 78.1–99.9). In-house DNA amplification methods and Xpert showed 93.6% concordance for lung tissue and 100% concordance for brain and liver tissues. The final cause of death was attributable to tuberculosis in four cases. Xpert MTB/RIF may represent a valuable, easy-to perform technique for post-mortem TB diagnosis.